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December 24, 2012

Meal Planning, Food and Diet, Other

Question from Beaumont, California, US:

My niece was diagnosed with type 1 diabetes yesterday. Her sugars were spiked so high she had to go into the ICU. While they are stabilizing her, my sister was wondering if she could continue breast feeding her daughter. who is almost two. It’s more for comfort now, being in the hospital, and all during Christmas. However, the doctors are saying she should not do so. Her pediatrician is saying it’s okay. My sister wants to comfort her daughter.


From: DTeam Staff

There is no contraindication to breast milk or breast feeding in type 1 diabetes. In fact, some (older) studies have even suggested that type 1 diabetes is less prevalent in children who did breast feed longer.

HOWEVER, having made these statements, I do not think it is a good idea RIGHT NOW for the toddler to nurse. She is in the Intensive Care Unit, perhaps not so much for the degree of glucose elevation, but her age and the potential (for) associated issues such as diabetic ketoacidosis (DKA) or brain swelling (cerebral edema) leave her in a precarious situation right now. Let her pediatric ICU team stabilize her. I would encourage the mother to continue to pump the milk, if she so desires.

A bit of forewarning: depending on the insulin plan that the little girl’s pediatric diabetes team will be using, they may be dosing insulin relative to food intake – certain caloric or degree of carbohydrate intake would call for specific amounts of insulin, per one type of intensive management plan (called a “basal-bolus” insulin plan). It will be difficult to quantitate intake if the child were to continue to nurse at the breast; breast milk fed via a bottle would be easier. Still, at age two, it is not unreasonable at all to discontinue breast milk.

I hope this helps. I encourage the family to attend the certified diabetes education sessions offered by the pediatric diabetes team with whom they are working.